Time to end battle against sense, mercy

Were we deemed to be at war, these would be condemned as war crimes, and I, as a medical practitioner, held accountable. And yet, though no word of it has reached our headlines, we are at war – a battle between what we know to be good and right and humane and decent, on the one hand, and the implacable, intractable juggernaut of religious dogma on the other. Dogma that insists – in the face of all the screaming evidence to the contrary – that life, no matter what its circumstances, is invariably preferable to its absence.

In order to examine this most persistent of notions, let’s journey down to what must rank as the Seventh Circle of Dante’s Inferno – the nursing home. Once there, let us look upon the abject beings that God has forgotten. Hear their nightmarish cries. Witness the slack and toothless jaw, the guttural gurgle that must pass for speech and the sickening slop that must pass for sustenance, the bruised and broken skin, the gnarled and twisted joint, the deaf ear and the emptiness, the endlessness, the repetition, the despair that makes up day after never-ending day. Witness this, and tell me there remains a shred of dignity within these walls. If any decent human being were to witness a dog in such dire straits, their hearts would go out to that poor creature and it would be put out of its misery. Ah – but the dog has no soul. O, for the soulless existence of a dog. If we could but jettison our souls and be accorded the same kindness, the same simple humanity that is extended to the dog. If we could but deny the so-called sanctity of our lives, if only for a moment.

At the Parkville Psychiatric Unit in Melbourne, there exists a museum of psychiatry – a grisly testament to the pursuit of sanctity. It is filled with the paraphernalia of kindness – leather restraints, primitive electrodes, straitjackets, cold-water therapy closets – things that were once thought to be at the cutting edge of the caring sciences.

Today, we see them for what they are – at best, instruments of inadvertent torture, at worst, the machinery of control. A hot shudder of shame passes over us as we witness what human beings once did to one another in the name of humanity. A hundred years from now, the Museum of the Nursing Home will evoke the same shudder of shame and horror in our descendants. Did we really do that to our loved ones? How could we not have recognised the brutality?

The church will plead that suffering is redemptive. I look upon these haggard, cracked and wisened creatures, lying in a deranged mire of their own filth, and what I see is irredeemable. Somehow, the simplistic tale of God’s son – in his immaculate suffering upon the cross – has become inextricably interwoven with the senseless torture of a bag of bones rotting slowly.

Palliative care physicians will tell us modern palliative practice can alleviate all this suffering. After 40 years as a medical practitioner – spending at least two hours in every day in close contact with nursing home patients – I can authoritatively tell you this is utter rot. Show me the magic pill that will alleviate shame, incapacity, indignity, decay, loneliness, unremitting boredom, utter hopelessness, self-loathing and, yes, even the star pupil in the palliative care physician’s armamentarium, pain.

Suffering is not redemptive. Particularly suffering that can be easily, humanely and painlessly brought to a swift end. It is cruel. It is pitiless. It is primitive. It is the sort of thing which, if there were a God of mercy, should make him weep with shame.